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Central vs. Obstructive Sleep Apnea

Central vs. Obstructive Sleep Apnea

Sleep apnea is a serious sleep disorder characterized by frequent pauses in breathing during the night. Pauses often occur multiple times per hour and can last 10 seconds or longer. During these pauses, the brain and the rest of the body are deprived of vital oxygen. Sensing your lack of oxygen, the brain rouses you awake (usually only partially so you're often unaware of it) to start breathing again. Most people don't know they have sleep apnea and are only made aware of it after visiting their doctor for symptoms of excessive daytime sleepiness and complaints by their partner of their intolerably loud snoring. The snoring sounds are a result of the air trying to squeeze its way around the blockage. While sleep apnea is a broad term for frequent pauses in nighttime breathing, there are actually two types of sleep apnea: obstructive sleep apnea and central sleep apnea.

Obstructive Sleep Apnea

Known as OSA for short, obstructive sleep apnea is the most common type of sleep apnea, affecting approximately 2% to 9% of people in the U.S. It's caused by a physical blockage of the airway, typically the muscles at the back of the throat that relax and collapse during sleep, obstructing the airway.

Symptoms of OSA

The telltale symptoms of OSA are loud snoring, waking up short of breath with a snort and periods of breathing cessation that's observed by a partner. Other symptoms include:

  • Excessive sleepiness during the day
  • Difficulty focusing and concentrating on daily tasks
  • Dry mouth and sore throat in the morning
  • Morning chest pain
  • Morning headaches
  • Mood changes: bouts of depression, anxiety or excessive irritability
  • Insomnia or restless sleep
  • Hypertension (high blood pressure): when oxygen level in the blood significantly decrease, blood pressure typically rises

Central Sleep Apnea

Unlike OSA, central sleep apnea is not caused by a blockage; rather, it's caused by a dysfunction of the respiratory control centers in the brain during sleep, failing to send the right signals to the muscles that control your breathing. Central sleep apnea may occur because of other medical conditions, including heart failure, stroke, neurological diseases such as Parkinson's disease, Alzheimer's disease and ALS; and damage caused to the brain stem by a stroke, encephalitis and other factors. It may also be caused by taking certain medications such as opioids which may cause breathing to become irregular as well as being in very high altitudes.

Symptoms of Central Sleep Apnea

In central sleep apnea, snoring is not as prominent as it is in OSA. In addition to feeling extreme fatigue during the day and experiencing abrupt awakenings during the night, other symptoms include:

  • Shortness of breath that's alleviated upon sitting up
  • Chest pain at night
  • Insomnia
  • Trouble concentrating at work or at school
  • Irritability and mood changes
  • Morning headaches

Treatment

While sleep apnea is a serious condition and sounds scary, treatment options are available and many find great success. If you have mild sleep apnea, your physician will likely start with lifestyle changes such as avoiding alcohol and medications that make you sleepy, losing weight if you're obese (even losing a little weight can improve symptoms), keeping your nasal passages open at night with nasal sprays or allergy medicines, if needed, and having you sleep on your side rather than your back which helps keep your airway open. For those who suffer from moderate to severe OSA and central sleep apnea, sleep devices such as CPAP (continuous positive airway pressure) machines have been found to be extremely beneficial. There are several types to choose from, including manual, automatic, BiPAP/VPAP and BiPAP/VPAP/BiLevel ST machines, as well as different masks. For central sleep apnea, certain medications may also be prescribed to stimulate the brain during sleep. Other options include specialized mouth guards and tongue restraining devices. Your physician will work with you to find the right type of device and fit so you'll stick with your treatment plan.

Don't Ignore Sleep Apnea

Left untreated, sleep apnea can have serious and life-threatening consequences: heart disease, stroke, diabetes, depression and other ailments. Moreover, untreated sleep apnea often leads to poor performance at work and at school and can lead to automobile accidents caused by falling asleep at the wheel.

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